The Nature of Determinism - The Reluctant Psychoanalyst Leads a Case Seminar

Presenting our clinical work to others is one of the most terrifying, and sometimes fun things that we analysts do.  There is a nakedness when we do this.  We are showing our work, and, while there will hopefully be moments where others appreciate and understand what we are doing, there will almost inevitably be criticism, which is hopefully presented in the spirit of being constructive, but exposes areas we have not thought of, interventions we did not make, and ways in which we have somehow failed the people, our patients, about whom we deeply care and whom we are invested in  helping.  Presenting our work to our peers can, thus, be terrifying.  I believe that the experience of presenting to our peers is parallel to the terror our patients feel when they are in a psychoanalytic - or, indeed - any exploratory therapy session.  The experience of terror is manifold, and I want to address one layer of it, though there are certainly many others.  When I ended my own analysis, I was flabbergasted at the amount of energy that I had.  On reflection, I surmised that one aspect of the increase in energy was that - though I consciously felt like I had settled into my analysis and had woven it into the context of the rest of my life - in fact, I think that I was girding my loins on a daily basis - preparing to see and be seen in a more naked and raw form, and that this was psychically expensive.

This week I substituted as the facilitator/teacher/supervisor in an ongoing clinical case conference.  The presenter was describing work that she was doing with a man, a man who had considerable difficulties and a man whom she was just beginning to get to know.  I noticed that the therapist and the man were working together to understand the man and how he functioned.  That is, the therapist would offer an interpretation of how the man had engaged in a particular action and she and the man together would evaluate how it is that he had done that.  The group, too, was engaging with the therapist in this way - how can we understand this man.  On the surface, this was a very psychoanalytic process, both between the therapist and the patient, and in the collegial interaction that the seminar participants were having with each other.  What, it can seem, could be more analytic than to be trying to understand what is causing a series of behaviors on the part of a client?  But I found both the clinical material and the discussion to be frustrating.  I felt, somehow, that we were missing something in the consulting room and now in our meeting room by focusing - I think prematurely - on the root causes of the behavior.

As I thought about it, and then talked about it, I realized that my frustration was based in part on the fact that we did not have access, in these interactions, to the man's feelings - to what his direct experience of the moment and of the world was.  I felt that the therapist's focus on the dynamics that were underlying the interactions the man was having felt premature or even defensive to me.  When I presented this position, there was some sense that it made sense and then we worked to try to get an understanding of why the therapist was working in this way (OK, I guess it's just what psychoanalysts do...).  I quickly realized, and pointed out to the group that we were again engaging in the same activity, but now it was taking place between the therapist and me.  That is, we were wondering about what the dynamics were that were leading the therapist to wonder with the patient about what was causing his behavior.

I asked the group and the presenter if we could try to approach the material differently.  I then asked her what she was feeling in the room.  She said that she wasn't sure, but she thought that she was feeling terrified.  This man she was treating was potentially suicidal and was alienating people who were important to him at work.  She wanted to support him so that bad things didn't happen.  She had, very early in the hour, offered a summary statement of some material that the patient had presented, and he experienced her observations, which the group did not see as deep at all, as coming in from left field - specifically he was relating what a person had told him and the content of that included a brush off.  When the therapist noted the brush off, he was surprised by it - he hadn't heard it and further was a little puzzled by how the therapist had heard it in that way - again something that was obvious to all of us in the room as a brush off.

So, as we talked further, it became clearer that the therapist was terrified not just of the circumstances surrounding this particular hour, but perhaps of the patient's demonstrated inability to accurately perceive and make use of information that others provided in emotionally charged interactions (as a therapy hour can be).  To allow him to describe his experience of the world can, then, become scary because we are moving further and further from what moors and tethers us to the world.  It felt like it would be better - meaning safer, and more supportive, to tell him about this world - through interpretations and through working with him to create a shared understanding of how he operates than to simply listen to his distorted understanding of the world, not knowing just how badly distorted it is.

This was a new understanding of what the therapist had been doing with the patient.  It was based not on her articulation of what she intended to be doing, but on discovering what was occurring - at least partly unconsciously - between the two of them.  Moving from the conceptual to the concrete, and simultaneously moving from the intellectual to the emotional, with the therapist trusting that this would be helpful, allowed us to think differently about what was taking place in the consulting room, and allowed something different to happen in the room between the therapist and I.  We had a new, shared understanding of what had happened, and we were more directly engaged with each other.

At this point, one of the participants asked a question that is typical for case conferences.  "So, what would you have done differently."  I was stumped.  I didn't have an answer, and I thought it would be unkind to offer an alternate way of intervening.  But the real reason for my being stumped didn't emerge until after the case conference.  And that was, there was no other way for the therapist to have intervened.  Given who she was, and who the client was, at that moment she did the best that she knew how to do.  She may have thought about other options - don't we often do that when we are engaged in any kind of conversation - but she could not, I don't believe, have said anything other than she did.  That is the nature of psychic determinism.  We do what we are determined to do.

This then, becomes the reason for a consultation or for a supervision session or for reading about the analytic process.  By engaging with other sources, we expand the possible ways of intervening.  The question is not what I would have done differently in that session, but what the analyst has available to do in the upcoming session that she might not have had before.  Will she be able to feel less tied to figuring everything out and be able to float a bit more on the sea of this man's thoughts?  Will that prove useful or it will it unmoor him and her?  Does he need the kind of work that she is doing with him?  Will this become apparent to them if she let's loose of the reins a bit?  Or might he become better able to describe his world when he is less worried about making sense of it?

It might seem that some of the questions in the last paragraph are rhetorical - as if I know what the answer is and am asking to make some kind of point.  In fact, I intend them as actual questions - questions that will, depending on what emerges from the interaction between the analyst and analysand if the analyst does engage differently, inform the analysis as it moves forward in an iterative process.

To access a narrative description of other posts on this site, link here.   For a subject based index, link here.

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The Life of Pi and Getting a Dog: The Reluctant Psychoanalyst Contemplates the ways that Life Imitates Art

The Life of Pi

We live in an urban neighborhood, one that was once grand, and still is, but it is now surrounded by decidedly mixed neighborhoods and ours becomes, periodically, the target for individuals or groups.  Most recently a group of teenagers has been going around the neighborhood, casing houses, and returning to those that are not well protected to rob them.  I stupidly left a basement door open after a weekend of working in the yard, and these kids discovered that and returned to rob us.  The reluctant wife was, understandably, furious about this (as was I).  She also felt violated and concerned about our well - being.  So she decided that we should act on a long held notion of getting a dog - not someday, but now.  She fell in love, on an internet website for adopting dogs saved from the pound, with Mack, a two year old bull mastiff mix who is, in person, a handful.  He is a delightful, exuberant dog who has, in the words of our dog trainer, not learned his manners, and our job is to teach them to him.  But to do this, we have to establish dominance and maintain it on a consistent basis.

That is also the task of Pi, in the book and now movie Life of Pi.  Named Piscine Molitor Patel after a beautiful swimming pool his Uncle enjoyed in Paris, Pi shortened his name when Piscine, which sounds like pissing when pronounced, became a way for his schoolmates to snicker at him.  The aggressive reclaiming of his identity by transforming it and owning it is a beautiful foreshadowing of what will be the center of the later narrative.

Born and raised in French Colonial India, an economic downturn leads the late adolescent Pi's family - he has an older brother, his mother who is the botanist in the family business, a zoo that his father, a business man, runs - to leave the country on a freighter with the animals from the zoo which they will sell to establish a new life in a new country.  They never get the opportunity to do that because the freighter sinks in a terrible storm and Pi ends up on a lifeboat inhabited by himself, an orangutan, a hyena, a zebra, a rat, and Richard Parker, a bengal tiger.  The zebra has a broken leg and is eaten, shortly after the rat, by the hyena, whom the orangutan hits.  The hyena then kills the orangutan and Richard Parker emerges from below the canvas, where he has apparently been sleeping off the effects of the seasickness medicine he was overdosed on, to kill the Hyena, leaving only he and Pi to face over two hundred days together on the open sea as they drift across the Pacific to finally make landfall in Mexico.

Pi was initially taken by Richard Parker when he shows up at the zoo.  He imagines that he sees some intelligence in his eyes and tries to connect with him.  Pi's father disagrees and asserts that Pi is merely seeing the reflection of his own soul in the eyes of the tiger.  Being stuck on a lifeboat with a tiger and a bunch of crackers let's Pi test his father's theory and discover how we mirror each other - as humans and as animals - as we engage with each other and, in the process, discover who it is that we are.

As harrowing as this story is - and it is harrowing, and here I offer a spoiler alert, it is not nearly as harrowing as the alternate plot.  Pi reveals this alternate to a writer who has come to hear his tale at the urging of Pi's Uncle.  After telling of surviving with Richard Parker, and Richard Parker disappearing into the Mexican jungle without so much as a look backwards, Pi tells the alternate version - that he was not on a lifeboat with animals at all, but with a sailor, the surly and subhuman cook from the freighter and his mother - oh, and a rat.  The sailor, like the zebra, had a broken leg.  The cook, after eating the rat, killed the sailor, in part to use his meat as bait - and perhaps to dine on him - and then kills Pi's mother in rage when she slaps him for his barbarian behavior.  Pi, a vegetarian pacifist, is horrified and angry.  When the cook leaves the knife that he used to kill the sailor unguarded, Pi murders him, unleashing a part of himself, portrayed by Richard Parker in the first version of the story; a wild, unbridled part that he is absolutely terrified by, but that also gives him the will to survive on the open sea as he struggles with and tries to protect and save himself - a person who is more complicated and dangerous than he ever had any idea.

The book and now the movie are brilliantly done.  The images in the movie powerfully bring to life a representation of the inner world that is rarely attempted on screen.  And it does so by persuasively telling the story of a boy surviving on a lifeboat - and the raft that he makes of life-preservers that he makes to float alongside the lifeboat - with a tiger - for over 200 days.  The boy must learn, in very tight quarters, to master the tiger.  To create separate spaces; his raft, but also places that he pees around on the boat; to kill fish (despite his abhorrence of killing); to leave an island they discover that would house them indefinitely, but that would also consume him; to wrestle with this animal and to care for it - despite his fear of it and his anger at all that it has destroyed.

The book and movie work on this level.  My struggles with Mack, while not as dramatic, mirror Pi's struggles with Richard Parker.  When Mack, who initially was friendly and more or less willing to go along with the program, first objected to a command, took a nip at me, and then growled and barked, I was both scared, but also angry and ready to assert myself; to become, in the current vernacular, the alpha dog.  I think that, when I do that in the rest of my life, I do it in such a cleverly hidden way that I can delude myself into thinking that I am not being aggressive.  I can, for instance, ask my son if he wants to take out the trash when what I am really saying is, "Take out the trash."  But with Mack, when he jumps on my bed and starts pulling at the covers with his teeth, my grabbing him in an instant by the scruff of the neck, lifting him into the air, then dropping him to the floor and forcing his neck to the ground to show him who is boss, all while saying quite firmly (bystanders might say shouting) "No, bad dog," there is no hiding my own aggression, my assertion, my commanding the situation.  For Pi, this is magnified, both by the contrast with his consistent, deeply held pacifism, and by the extreme aggression with which he has to engage a tiger - not to mention the fear that he will become his next meal.

I can return my Richard Parker to the pound.  The thieves have been caught, and, for now, there is no imminent threat.  Pi could, theoretically, kill Richard Parker, until we remember the other version of the story.  The only way to kill Richard Parker is to kill himself - an act of violence that will require Richard Parker's cooperation - meaning he will need to engage his own violence to bring about his death, but he is working to tame - to limit - to humanize - the very primitive force that he would need to kill himself.  And the convolutions in that last sentence illustrate the wonderful thing about this narrative device:  Yann Martel, the author of the book, and Ang Lee, the director of the movie, have figured out how to portray internal, psychological struggles, struggles that are ineffable and difficult to witness, even or especially from the inside, in vivid, concrete fashion.  Because it is through our engagement with the world, whether talking with our friends (or analyst), training a dog (or a tiger), or surviving in an open craft in the Pacific, that our unconscious selves emerge, guiding the (somewhat) conscious actions of engaging with, battling, anticipating and parrying to maintain our physical and/or psychological well being.  And thus the story of Richard Parker brings to life what would otherwise be a dramatic but invisible story, one that we would not be able to follow - the struggles between a man's conscience and his knowledge of the actions he engaged in when enraged as he is swept across the ocean by wind and waves.

To access a narrative description of other posts on this site, link here.     For a subject based index, link here.

 Post script:  We did ultimately return the dog.  When it was continuously threatening and scaring the children - jumping on their beds and growling at them - and tearing up whatever was in reach while we were out of the house and it was caged - it was too much even for the the reluctant wife.  Much later we did a sweet dog that was found after it had survived one of the coldest winters on record on its own.  It is small enough that I can comfortably return to being largely unaware of how frequently I assert my alpha dogness.

To subscribe to posts (which occur 2-3 times per month), if you are on a computer, hit the X button on the upper right of this screen and, on the subsequent screen, hover your cursor over the black line in the upper right area and choose the pop out box that says subscribe and then enter the information.  I'm sorry but I don't currently know how you can subscribe from a mobile device - hopefully you have a computer as well...